Prognostic Value of Blood Urea Nitrogen to Serum Albumin Ratio in Intensive Care Unit Patients with Lung Cancer

Peng, Xiulan; Huang, Yali; Fu, Haifeng; Zhi, Zhang; He, Anbing; Luo, Rong

doi:10.2147/ijgm.s337822

Cited by 23 publications

(32 citation statements)

References 45 publications

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“…A strong association has been reported between BUN levels and mortality due to sepsis (19). The blood urea nitrogen to serum albumin ratio (BAR), which combines nutritional status and renal status, has recently been found to be a valuable tool for predicting mortality in critically ill patients (20). The BAR is thought to be related to the nutritional status of the organism, dehydration status, and liver and kidney functional reserves (21).…”

Section: Introductionmentioning

confidence: 99%

Association between blood urea nitrogen to serum albumin ratio and in-hospital mortality of patients with sepsis in intensive care: A retrospective analysis of the fourth-generation Medical Information Mart for Intensive Care database

et al. 2022

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BackgroundThis study aimed to investigate the relationship between the blood urea nitrogen to serum albumin ratio (BAR) and in-hospital mortality in patients with sepsis.Materials and methodsThis is a retrospective cohort study. All septic patient data for the study were obtained from the intensive care unit of Beth Israel Deaconess Medical Center. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using multivariable Cox regression analyses. Survival curves were plotted and subgroup analyses were stratified by relevant covariates.ResultsAmong 23,901 patients, 13,464 with sepsis were included. The overall in-hospital mortality rate was 18.9% (2550/13464). After adjustment for confounding factors, patients in the highest BAR quartile had an increased risk of sepsis death than those in the lowest BAR quartile (HR: 1.42, 95% CI: 1.3–1.55), using BAR as a categorical variable. When BAR was presented as a continuous variable, the prevalence of in-hospital sepsis-related death increased by 8% (adjusted HR: 1.08, 95% CI: 1.07–1.1, P < 0.001) for each 5-unit increase in BAR, irrespective of confounders. Stratified analyses indicated age interactions (P < 0.001), and the correlation between BAR and the probability of dying due to sepsis was stable.ConclusionBAR was significantly associated with in-hospital mortality in intensive care patients with sepsis. A higher BAR in patients with sepsis is associated with a worse prognosis in the ICU in the USA. However, further research is required to confirm this finding.

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Section: Introductionmentioning

confidence: 99%

Association between blood urea nitrogen to serum albumin ratio and in-hospital mortality of patients with sepsis in intensive care: A retrospective analysis of the fourth-generation Medical Information Mart for Intensive Care database

et al. 2022

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“…An ideal biomarker should be easily accessible, inexpensive, non-invasive, and reflects the specific pathophysiological mechanisms of a disease ( 4 ). The blood urea nitrogen (BUN) to serum albumin ratio (BAR) is an emerging biomarker and was demonstrated to be linked with lung cancer and even COVID-19 ( 5 , 6 ). The prognostic significance of blood urea nitrogen has been demonstrated in various cardiovascular diseases, including acute coronary syndromes (ACS), acute myocardial infarction (AMI), heart failure (HF) ( 7 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

Elevated Blood Urea Nitrogen to Serum Albumin Ratio Is an Adverse Prognostic Predictor for Patients Undergoing Cardiac Surgery

Liu

Shi

Wang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundElevated blood urea nitrogen (BUN) and reduced albumin have been prominently correlated with unfavorable outcomes in patients with cardiovascular diseases. However, whether combination BUN and albumin levels could predict the adverse outcomes of cardiac surgery patients remains to be confirmed. Here, we investigated the prognostic effect of the preoperative BUN to serum albumin ratio (BAR) in cardiac surgery patients.MethodsData were obtained from the Medical Information Mart for Intensive Care (MIMIC) III and eICU databases and classified into a training cohort and validation cohort. The BAR (mg/g) was calculated by initial BUN (mg/dl)/serum albumin (g/dl). The primary outcome was in-hospital mortality. Secondary outcomes were 1-year mortality, prolonged length at intensive care unit, and duration of hospital stay. The associations of BAR with outcomes were explored by multivariate regression analysis and subgroup analyses. Then, C statistics were performed to assess the added prognostic impact of BAR beyond a baseline risk model.ResultsPatients with in-hospital death had significantly higher levels of BAR. Multivariate regression analysis identified BAR, as a categorical or continuous variable, as an independent factor for adverse outcomes of cardiac surgery (all p < 0.05). Subgroup analyses demonstrated a significant relationship between elevated BAR and in-hospital mortality in different subclasses. The addition of BAR to a baseline model provided additional prognostic information benefits for assessing primary outcome. Results were concordant in the external validation cohort.ConclusionsIncreased preoperative BAR is a potent predictor of unfavorable outcomes in patients undergoing cardiac surgery.

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“…In recent years, blood urea nitrogen to albumin ratio (B/A) has been discovered to be an important prognostic biomarker, combining urea nitrogen with albumin, two important predictors. Previously, studies on the prognosis of disease based on B/A have focused primarily on lung diseases, such as pneumonia [ 9 , 23 , 24 ], pulmonary embolism [ 10 ], and lung cancer [ 25 ], and it has been established that elevated B/A had a high predictive value for mortality. The recent studies have also demonstrated that elevated B/A may play a role in prognosticating chronic heart failure [ 11 ], Escherichia coli bacteremia [ 26 ], and gastrointestinal bleeding [ 27 ], which also broaden our perspective.…”

Section: Discussionmentioning

confidence: 99%

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

Min

Zhong

et al. 2022

BMC Anesthesiol

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Background Sepsis is a common critical illness in intensive care unit (ICU) and seriously threatens the life of patients. Therefore, to identify a simple and effective clinical indicator to determine prognosis is essential for the management of sepsis patients. This study was mainly based on blood urea nitrogen to albumin ratio (B/A), a comprehensive index, to explore its correlation with the prognosis of sepsis patients during hospitalization. Methods Totally, adult patients in ICU who were diagnosed with sepsis in Medical Information Mart for Intensive Care IV(MIMIC-IV) database from 2008 to 2019 were involved in this study. The study population were divided into survivors group and non-survivors group based on the prognosis during hospitalization. Restricted cubic spline (RCS) was utilized to analyze the association between B/A level and the risk of ICU all-cause mortality in patients with sepsis and determine the optimal cut-off value of B/A. The study population was divided into low B/A group and high B/A group based on the optimal cut-off value. The survival curve of ICU cumulative survival rate was draw through Kaplan–Meier method. The correlation between B/A and the prognosis of patients was conducted by multivariate Cox regression analysis. Furthermore, we performed sensitivity analyses to assess the robustness of the results. Results A total of 10,578 patients with sepsis were enrolled, and the ICU all-cause mortality was 15.89%. The patients in the non-survivors group had higher B/A values and more comorbidities than those in the survivors group. RCS showed that the risk of ICU all-cause mortality increased with the B/A level, showing a non-linear trend (χ2 = 66.82, p < 0.001). The mortality rate in the high B/A group was significantly higher than that in the low B/A group (p < 0.001). Kaplan–Meier curves revealed that compared with the low B/A group, the ICU cumulative survival rate of patients with sepsis was significantly lower in the high B/A group (log-rank test, χ2 = 148.620, p < 0.001). Further analysis of multivariate Cox proportional hazards regression showed that an elevated B/A (≥ 7.93) was an independent factor associated with ICU mortality among patients with sepsis. Conclusions An elevated B/A might be a useful prognostic indicator in patients with sepsis. This study could offer a deeper insight into treating sepsis.

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Prognostic Value of Blood Urea Nitrogen to Serum Albumin Ratio in Intensive Care Unit Patients with Lung Cancer

Cited by 23 publications

References 45 publications

Association between blood urea nitrogen to serum albumin ratio and in-hospital mortality of patients with sepsis in intensive care: A retrospective analysis of the fourth-generation Medical Information Mart for Intensive Care database

Association between blood urea nitrogen to serum albumin ratio and in-hospital mortality of patients with sepsis in intensive care: A retrospective analysis of the fourth-generation Medical Information Mart for Intensive Care database

Elevated Blood Urea Nitrogen to Serum Albumin Ratio Is an Adverse Prognostic Predictor for Patients Undergoing Cardiac Surgery

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

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